Peripheral vascular disease evaluated with reduced-dose gadolinium-enhanced MR angiography.
Peripheral vascular disease evaluated with reduced-dose gadolinium-enhanced MR angiography.
复制标题
通过减少剂量钆增强磁共振血管造影评估周围血管疾病。
作者：
Neil M. Rofsky;Glyn Johnson;M. Adelman;Robert J. Rosen;G. Krinsky;J. Weinreb
目的
旨在证明两个连续解剖区域的低剂量钆增强磁共振（MR）血管造影在评估外周血管疾病中的实用性。
材料和方法
15例患者在常规数字减影血管造影（DSA）后接受了钆增强MR血管造影，以评估下肢周围血管疾病。磁共振血管造影进行三维冠状梯度回波采集之前和期间的管理钆喷酸葡胺。使用0.075和0.1 mmol/kg剂量的钆喷酸葡胺对两个独立的连续区域进行了研究。将MR血管造影结果与DSA结果进行比较，DSA为参考标准。首先通过MR血管造影片确定治疗方案，然后通过DSA图像确定治疗方案。
结果
对于区分大于50%的狭窄和小于50%的狭窄，钆增强MR血管造影的敏感性为97%，特异性为96%，准确性为97%。在150个解剖节段中，有146个（97%）与MR血管造影和DSA确定的治疗方法基本或完全一致。在2例病例中（1例血管支架置入术和1例手术吻合术），MR血管造影高估了疾病范围。一个膝下区域的MR研究不足以进行评价。
结论
在大多数患者中，使用小于0.2 mmol/kg的造影剂即可对下肢多个外周血管区域进行准确的钆增强MR血管造影。
PURPOSE
To demonstrate the utility of low-dose gadolinium-enhanced magnetic resonance (MR) angiography of two consecutive anatomic areas for assessment of peripheral vascular disease.
MATERIALS AND METHODS
Fifteen patients underwent gadolinium-enhanced MR angiography for evaluation of lower extremity peripheral vascular disease after conventional digital subtraction angiography (DSA). MR angiography was performed with three-dimensional coronal gradient-echo acquisitions before and during administration of gadopentetate dimeglumine. Two separate, contiguous areas were studied with separate doses of 0.075 and 0.1 mmol/kg gadopentetate dimeglumine. MR angiography findings were compared with DSA findings; DSA was the standard of reference. Treatment options were determined first with MR angiograms and then with DSA images.
RESULTS
For distinguishing greater than 50% stenosis from 50% or less stenosis, gadolinium-enhanced MR angiography yielded a sensitivity of 97%, a specificity of 96%, and an accuracy of 97%. In 146 (97%) of 150 anatomic segments, there was essential or total agreement on treatments determined with MR angiography and DSA. In two cases (one case of vascular stent placement and one case of surgical anastomosis), extent of disease was overestimated with MR angiography. The MR study of one infrapopliteal area was insufficient for evaluation.
CONCLUSION
Accurate gadolinium-enhanced MR angiography of multiple peripheral vascular areas of the lower extremities can be performed in most patients with less than 0.2 mmol/kg contrast material.